RADIOGRAFIC ASSESTMENT AND JOINT DAMAGE IN EARLY RHEUMATHOID ARTHRITIS PATIENTS TREATS WITH METHOTREXATE
Abstract
In rheumatoid arthritis (RA), progression of the radiographic damage of hand and feet joints is a significant and objective variable for evaluation of disease activity as well as measurement of treatment outcome. The aim of this study was to evaluate the RA activity with radiographic evaluation of hand joints in patients with early RA treated with Methotrexate by using acute phase reactants, as rheumathoid factor (RF), C-reactive protein (CRP) and DAS28 index of disease activity. We tested 70 participants (35 control patients, 35 untreated RA patients). Patients were treated with Methotrexate at an average dose of 10 mg once weekly. For clinical evaluation of disease activity radiographic index (RI), sedimentation, CRP and RF in certain time intervals (0-time, after 6, 9 and 12 months) were analyzed in every patient. RI showed an increased radiographic progression of hand joint damage in time intervals between 0-time and 9 months (p=0,0167) and between 0-time and 12 months (p=0.0089). The statistical analysis showed statistically significant differences among mean values of ESR in the four-time intervals (p=0.00002).
Keywords: rheumatoid factor, acute phase reactants, rheumatoid arthritis
https://doi.org/10.55302/JMS2142026s
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damage and the acute phase response in early rheumatoid arthritis. Towards a decision support system. J
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20. O' Dell JR. Therapeutic strategies for rheumatoid arthritis. N E J Med 2004; 350 : 2591 -602.
21. Belghomari H, Saraux A, Allain J, Guedes C, Youinou P, Goff PL. Risk factors for radiographic articular
destruction of hands and wrists in rheumatoid arthritis. J Rheumatol 1999; 26: 2534-8.
22. Capell HA, Porter DR, Madhok R, Hunter JA. Second line ( disease modifying) treatment in rheumatoid
arthritis: which drug for which patient? Ann Rheum Dis 1993; 52 :423-8.
23. Hoekstra M,van Ede AE, Haagsma CJ. Factors associated with toxicity, final dose, and efficacy of methotrexate
in patients with rheumatoid arthritis. Ann Rheum Dis 2003; 62: 423-6.
24. Van der Heide A, Remme CA, Hoffman DM, Jacobs JWG, Bijlsma JWJ. Prediction of progression of radiographic
damage in newly diagnosed rheumatoid arthritis. Arthritis Rheum 1995; 38 : 146-75.
25. Jansen LMA, van der Horst - Bruinsma IE, van Schaardenburg D, Bezemer PD, Dijkmans BAC. Predictors of
radiographic join damage in patients with early rheumatoid arthritis. Ann Rheum Dis 2001; 60: 924-027
26. Michael JP, Arnold LW, O'Sullivan MM, Lewis PA, Coles EC, Jessop JD. Relationship between time- integrated c-
reactive protein levels and radiologic progression in patients with rheumatoid arthritis. Arthritis Rheum
2000; 43 : 1473 - 1477.
LB UK: Mosby International Lynton House 7-12 Tavistock Square; 1998. Chapter 5 : 5.1.
2. Kuper IH, Van Leeuwen MA, Van Riel PLCM, Sluiter WJ, Houtman NM, Cats HA, Van Rijswijk MH. Influence of a
ceiling effect on the assessment of radiographic progression in rheumatoid arthritis during the first 6 years of
disease. J Rheumatol 1999; 26:268-76.
3. Larsen A, Thoen J. Hand radiography of 200 patients with rheumatoid arthritis repeated after an interval of
one year. Scand J Rheumatology 1987; 16 : 395 -401.
4. Belghomari H, Saraux A, Allain J, Guedes C, Youinou P, Goff PL. Risk factors for radiographic articular
destruction of hands and wrists in rheumatoid arthritis. J Rheumatol 1999; 26: 2534-8.
5. Sharp JT, Lidsky MD, Collins LC, Moreland J. Methods of scoring the progression of radiologic changes in
rheumatoid arthritis. Arthritis Rheum 1971;14 :706-720.
6. Molenaar ETH, Edmonds J, Boers M, van der Heijde DMFN, Lassere M. A practical exercise in reading RA
radiographs by the Larsen and Sharp methods. J Rheumatol 1999; 26: 746-8.
7. Guillemin F, Billot L, Boini S, Gerard N, Odegaard S, Kvien TK. Reproducibility and sensitivity to change of 5
methods for scoring hand radiographic damage in patients with rheumatoid arthritis . J Rheumatol 2005; 32:
778-86.
8. Williams AL, O'Sullivan MM, Lewis PA, Coles EC, Jessop JD. Relationship between time-integrated c-reactive
protein levels and radiologic progression in patients with rheumatoid arthritis. Arthritis Rheum 2000 ; 43 : 1473-
1477.
9. Kirwan JR. The relationship between synovitis and erosions in rheumatoid arthritis. Br J Rheumatol 1997 ; 36 :
225-228
10. Mottonen T, Paimela L, Leirisalo-Repo M, Kautiainen H, IIonen J, Hannonen P: Only high disease activity and
positive rheumatoid factor indicate poor prognosis in patients with early rheumatoid arthritis treated with
"sawtooth" strategy. Ann Rheum Dis, 1998; 57(9) : 533-9.
11. Mauricie E, Jeurissen MD; Agnes M, Boerbooms T. MD, PhD; Levinus BA, van de Putte, MD, PhD; , Doesburg
WH, NSc; Lemmens AM, MD, . Influence of methotrexate and azathioprine on radiologic progression in
rheumatoid arthritis. Ann Intern Med 1991; 114:999-1004.
12. Weinblatt ME, Trentham DE, Fraser PA. Long-term prospective trial of low-dose methotrexate in reheumatoid
arthritis. Arthritis Rheum 1988;31:167-75.
13. Kremer JM, Phelps CT. Long - term prospective study of the use of methotrexate in the treatment of
rheumatoid arthritis: update after a mean of 90 months. Arthritis Rheum 1992; 35: 138- 45.
14. Reykdal S, Steinsson K, Sigurjonsson K, Brekkan A. Methotrexate treatment of rheumatoid arthritis: effects on
radiological progression . Scand J Rheumatol. 1989 ; 18 : 221-6.
15. Strand V, Sharp JT Radiographic data from recent randomized controlled trials in rheumatoid arthritis.
Arthritis Rheum 2003; 48: 21-34.
16. Van Leuwwen MA, van Rijswijk MH, Sluiter WJ. Individual relationship between progression of radiological
damage and the acute phase response in early rheumatoid arthritis. Towards a decision support system. J
Rheumatol 1997; 24:20-7.
17. Visser H, le Cessie S, Vos K, Breedveld FC, Hazes J. How to diagnose rheumatoid arthritis early: a prediction
model for persistent( erosive) arthritis. Arthitis rheum 2002; 46: 357-65.
18. Redlich K, Hayer S, Ricci R. Osteoclasts are essential for TNF-a-mediated joint destruction. J Clin Invest 2002;
110:1419-27.
19. Joosten LA,Lubberts E, Helsen MM. Protection against cartilage and bone destruction by systemic interleukin
4 treatment in established murine type ii collagen - induced arthrits. Arthritis Res 1999; 1 : 81- 91.
20. O' Dell JR. Therapeutic strategies for rheumatoid arthritis. N E J Med 2004; 350 : 2591 -602.
21. Belghomari H, Saraux A, Allain J, Guedes C, Youinou P, Goff PL. Risk factors for radiographic articular
destruction of hands and wrists in rheumatoid arthritis. J Rheumatol 1999; 26: 2534-8.
22. Capell HA, Porter DR, Madhok R, Hunter JA. Second line ( disease modifying) treatment in rheumatoid
arthritis: which drug for which patient? Ann Rheum Dis 1993; 52 :423-8.
23. Hoekstra M,van Ede AE, Haagsma CJ. Factors associated with toxicity, final dose, and efficacy of methotrexate
in patients with rheumatoid arthritis. Ann Rheum Dis 2003; 62: 423-6.
24. Van der Heide A, Remme CA, Hoffman DM, Jacobs JWG, Bijlsma JWJ. Prediction of progression of radiographic
damage in newly diagnosed rheumatoid arthritis. Arthritis Rheum 1995; 38 : 146-75.
25. Jansen LMA, van der Horst - Bruinsma IE, van Schaardenburg D, Bezemer PD, Dijkmans BAC. Predictors of
radiographic join damage in patients with early rheumatoid arthritis. Ann Rheum Dis 2001; 60: 924-027
26. Michael JP, Arnold LW, O'Sullivan MM, Lewis PA, Coles EC, Jessop JD. Relationship between time- integrated c-
reactive protein levels and radiologic progression in patients with rheumatoid arthritis. Arthritis Rheum
2000; 43 : 1473 - 1477.
Published
2021-07-26
How to Cite
SPASOVSKI, Dejan et al.
RADIOGRAFIC ASSESTMENT AND JOINT DAMAGE IN EARLY RHEUMATHOID ARTHRITIS PATIENTS TREATS WITH METHOTREXATE.
Journal of Morphological Sciences, [S.l.], v. 4, n. 2, p. 26-34, july 2021.
ISSN 2545-4706.
Available at: <http://jms.mk/jms/article/view/vol4no2-4>. Date accessed: 16 nov. 2024.
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